In many countries across the world, the word “heartworm” is enough to make vets and pet owners shudder. This potentially fatal parasite has infected pets all over the world. While mosquitoes don’t carry infections in the UK, that doesn’t mean our pets are off the hook from heartworm. With the numbers of people and their pets travelling internationally picking up since Covid AND significantly increased numbers of pet adoption outside the UK, our pets are all but safe from heartworm infection. So if you’re travelling abroad with your pet or have adopted them from a warm climate, keep an eye out for Heartworm. 

What is heartworm?

Heartworm is the general term used to describe infection with the parasitic worm Dirofilaria immitis. This worm makes its home within the heart, as well as the blood vessels in the heart and lungs. 

*While heartworm can have a similar end location and clinical signs as lungworm (Angiostrongylus in dogs, Aelurostrongylus in cats), these are different parasites and have differing life cycles. For more on lungworm, check out our lungworm blog!

How do pets get infected with heartworm?

Unlike many of our other common worms, heartworm is NOT TRANSMITTED DIRECTLY from pet to pet via faeces. Heartworm is spread via mosquito bite. A mosquito bites an infected animal and consumes the blood containing intermediate heartworm larvae. The mosquito then moves to take its next blood meal from another pet and transmits the larvae into this animal’s bloodstream. The larvae mature and travel to the heart/lungs where adult heartworms make themselves at home and begin causing problems.

What are signs my pet might be infected with heartworm?

Signs of heartworm infection can range from mild to severe. It may be as simple as lethargy or decreased appetite. More severe signs can include vomiting, diarrhea, coughing, exercise intolerance, and even collapse. These clinical signs are a result of damage to the heart and vessels from adult heartworms. In cases of advanced untreated infection, pets can die from this dangerous parasite.

Can my vet test my pet for heartworm?

Absolutely! There are a few ways your vet can test for heartworm, all primarily via blood. The simplest version is a test looking for heartworm antigen in the blood. This means the lab is looking for evidence of what heartworm produces that the immune system responds to. If this comes up positive, then another fresh blood sample is submitted looking for microfilariae in the blood. Microfilariae are the immature larval form of heartworm that float freely in the bloodstream. 

Oftentimes, x-rays of the chest are also performed looking for enlargement of the heart and pulmonary blood vessels to help determine how advanced the infection may be. 

Can heartworm be treated?

Heartworm can be treated, but it is a majorly time consuming and costly process. The treatment regimen also comes with risks. Pets that are positive for heartworm are treated with injections of a strong adult worm immiticide deep in the muscles of the back. They must also be placed on steroids to decrease the inflammation that the body will create in response to the major killing off of the worms. In addition, pets are placed on an antibiotic to kill the bacteria Wolbachia, which is released by heartworms into the blood when they die. Lastly, pets are also placed on monthly heartworm preventatives as a part of the treatment protocol. Pets are required to be restricted to a cage or small confined space during treatment, as exerting activity like playing or running may exacerbate release of dead worms that travel into the lungs and block small blood vessels. 

Help! What can I do as a pet owner?

We can’t emphasize enough how important year round consistent parasite prevention is. Prevention is always better than treatment, especially in the case of heartworm. Particularly, if you have adopted a pet from another European country OR if you are traveling internationally with your pets from the UK, it is important to ensure these animals are tested for heartworm and on the appropriate prevention. A negative test is recommended prior to beginning regular prevention.

Fortunately, most of the prescription preventatives/treatments that cover LUNGWORM will also cover HEARTWORM, so if you are using a monthly treatment that gets lungworm it’s likely your pet is also protected against heartworm. That being said, it is important to check the product label to see if the drug is licensed to prevent maturation of Dirofilaria immitis. These preventatives must be given every 4 weeks consistently year round to be effective. Missing one dose in areas endemic for heartworm can result in infection. 

VetBox Top Tip: 

Once again our favorite theme rings true, consistent responsible parasite prevention is essential for healthy pets! 

Dr. Kirsten Ronngren, DVM MRCVS

We often only seek medical advice or treatment to cure our pets once they have fallen ill. 

But, like with human medicine, prevention is nearly always better than treatment as it saves you time, hassle and money in the long run. Especially when it comes to fleas and ticks as you and your pet can get seriously ill from them. We found that not enough people are choosing to prevent rather than cure so the team here at VetBox sought to change things. 

Read on to find out why parasite prevention is better than parasite treatment!

Why prevention is best:

Fleas are irritating!

Imagine feeling itchy or like something is biting you over and over but you can’t seem to get it to stop. Pets with infestations are uncomfortable and often stressed as well. 

Fleas carry diseases that can make your pet (and you) unwell

Fleas can be the source of diseases like Mycoplasma and Bartonella in cats, and historically were known to be carriers of human diseases like the bubonic plague and typhus (yuck!). Fleas also are known to carry the species of tapeworm Dipylidium, and pets that ingest infected fleas will often develop the GI tapeworm. 

Ticks ALSO carry diseases that can make you and your pet unwell. 

While there is a long list of serious tickbourne illnesses known, one major one in the UK affecting both pets and people is Lyme disease. Lyme disease can cause acute illness in pets and people including fever, lethargy and joint pain. While acute disease can be managed, there are often long term health implications. 

Fleas can be challenging and time consuming to get rid of. 

All pets in the house will need to be treated monthly for at least a few months. You also have to clean the house multiple times to break the flea life cycle. 

Just because you don’t SEE fleas, doesn’t mean they aren’t or haven’t been there. 

Fleas are small and quick. Even just a few adults can cause irritation or spread disease. Females can lay 40 eggs each per day! Eggs can be seen with the naked eye but are even harder to spot. 

Some pets are actually allergic to flea saliva, and prone to a condition called flea allergy dermatitis. 

These pets have a more severe reaction to even just a single flea bite! FAD can cause major redness, hair loss, skin infections, and pain for your pets. While regular flea prevention is important for all pets, for those suffering from FAD it’s a must!

Costs of treatment for flea or tick borne disease can be immense and ongoing.

Flea and tick prevention will always be more cost effective for owners over treating existing disease. 

Owner costs at the vet for severe cases of flea allergy dermatitis can easily reach several hundred pounds per trip, and in more serious cases like cats sick from Mycoplasma or dogs that acquire Lyme disease, treatment costs easily can reach the thousands of pounds range. 

For more information about prevention, you can contact VetBox’s friendly support staff to help!

Zoonosis is the term used to describe diseases that can be passed from animals to people. I think in general people are aware that this can happen, but we don’t believe people realize the vast number of zoonoses actually out there. In many circumstances these diseases seem foreign or far away, but the reality is there are several of these that have the potential to be in your back garden, or even your home. The purpose of this is not to overwhelm pet owners, but to make people aware of these potential risks so that we can prevent problems before they arise. 

Let’s start by reviewing some parasites that humans can contract from their pets:

Parasite causes:

Roundworms: 

Roundworms in dogs and cats are one of our most common parasites. These species can however, if introduced to the human GI tract by kisses from your furry family member, can develop and migrate to other organ systems and cause issues. 

Hookworms: 

Similar to their roundworm counterparts, hookworms also don’t mind infecting people. These pesky creatures are known to cause the condition visceral larval migrans (larvae migrate to other organs in the body like the brain or the eye) and cutaneous larval migrans (larvae migrate just under the skin). This can cause serious consequences especially in young children.

Tapeworms:

Most tapeworms tend to be species specific, i.e. they prefer one main host like a dog or a cow. That being said, the flea spread tapeworm Dipylidium can infect humans and mature in the gut. Additionally, immature Taenia spp. tapeworm life stages can be found in raw or undercooked meat, meaning if you or your pet consumes these, risk for tapeworm infection is possible. 

One to note in this category is the species Echinococcus. This nasty tapeworm is the culprit behind hydatid cyst disease. While the dog is it’s preferred host, both humans and sheep can act as intermediate hosts and develop potentially life threatening cysts within the body full of immature tapeworms.

Scabies (mange): 

Dogs and cats can develop infestations with two major types of mites, including Demodex and Sarcoptes. While Demodex spp. Are not contagious, humans may become infected by Sarcoptes mites, leading to itching and severe skin irritation. 

Bacterial causes:

Lyme disease: 

This is most commonly recognized as a tick borne disease, however the symptoms are caused by a bacteria called Borrelia burgdorferi. Borrelia can cause severe clinical signs in ourselves and our pets. 

Bartonella:

Cat scratch fever is actually caused by a bacteria. This can cause infected cats to develop fever and other signs, and can be transmitted to humans via cat scratch.

Salmonella, E. coli, and Campylobacter:

These are all bacteria that are not only a potential risk of causing GI problems if they infect humans/pets consuming raw or undercooked meats, but they can also be spread via the feces of pet bird species (including chickens).

Rocky Mountain Spotted Fever: 

Similar to lyme disease, RMSF is also spread by ticks and is caused by the bacteria Rickettsia rickettsii. This can cause rash, fever, headache, lethargy, etc. and can be serious. While uncommon in the UK, travellers coming back from Europe should be aware of ticks abroad.

Leptospirosis species: 

Leptospirosis spp. are a group of bacteria that are spread via the urine of affected animals, including dogs. If urine of an infected animal gets into the mucus membranes of another (eyes, mouth, nose) then clinical disease may occur. Signs of leptospirosis infection in dogs are typically general including lethargy, vomiting, fever, increased drinking or urination, and decreased appetite. Elevations in kidney or liver values on bloodwork are a concern as these organs are the target. Leptospirosis is currently uncommon in the UK, but is being diagnosed and is a disease you don’t want to get to know. *See later note on vaccinations in dogs*

Coxiella burnetii: 

The causative agent of Q fever, Coxiella is shed in urine, feces, milk, and birth fluid of ruminants (sheep primarily) and can then be spread to humans to cause a range of signs including fever, cough, vomiting, diarrhea, and lethargy. 

Fungal causes:

Ringworm: 

Dermatophytosis, better known as ringworm, is a fungal infection of the top layers of the skin. Canine and feline dermatophytosis is extremely common, especially in shelter/rescue scenarios because of large animals in close proximity. Puppies and kittens are often the source in humans soon after adoption. Ringworm can be spread between animals and to humans via direct contact or by contaminated surfaces. 

Protozoal causes: 

Giardia spp.: 

While most species of this protozoal organism tend to be species specific in terms of who they like to infect, it’s important to keep in mind that people can technically still become infected with Giardia from their pet. Giardia is a faecal “parasite” that comes from the faeces of another infected animal. More commonly people and pets become infected from the same contaminated water source containing faecal material while out hiking or camping. This is a common cause of vomiting and diarrhea in pets.

Toxoplasma gondii:

Many people have heard of Toxoplasma but don’t realize it. This is the organism that causes people to warn pregnant women to not scoop the litter box. Toxoplasma is transferred via cat faeces. Cats may show clinical signs of illness including neurologic problems, but they can also pass oocysts asymptomatically. If this parasite makes its way into humans, problems with the fetus in pregnant women may arise. A good excuse to make your non-pregnant partner scoop the box! 

While this list is nowhere near exhaustive, (think many, many more), it does list some of the more common diseases we see, especially those parasites that like to infest our companion animals. This reminds us why regular targeted parasite prevention is extremely important. It helps keep not only our pets safe, but ourselves and our families healthy too. Checking with a vet to ensure your pet is appropriately vaccinated is equally essential, particularly in the case of leptospirosis. Vaccination will not prevent exposure, but it will lessen the likelihood of developing severe disease as well as hopefully decrease the amount of bacteria shed. Not all zoonotic diseases can be kept at bay with parasite prevention or vaccination, which is why education and good personal hygiene associated (hand washing) with animal handling is a must.

What next: 

Making sure your pet is appropriately wormed and vaccinated for your/their lifestyle and location is an ESSENTIAL part of keeping our community healthy; pet and owners alike! 

For more information on significant parasites and zoonotic diseases, check out the following resources: 

European Scientific Council for Companion Animal Parasites

https://www.esccap.org/national-associations/UK+and+Ireland/11/

European Centre for Disease Prevention and Control 

https://www.ecdc.europa.eu/en/zoonoses

Dr. Kirsten Ronngren, DVM MRCVS

There are more than a few organisms out there that can be passed from pets to people. One we often forget is the fungi better known as “ringworm”. Also referred to as dermatophytosis, ringworm can be spread from animals to people in addition to person-person and animal-animal transmission. On today’s blog we’re going to go over the most important things pet owners should know about ringworm.

What exactly is ringworm?

Even though it’s most widely known as a “worm”, ringworm is actually caused by infection with a fungus. 

Ringworm in pets is caused by one of two species; Microsporum canis or Trichophyton mentagrophytes. Both of these are zoonotic which means they can also infect humans. 

How do pets get ringworm?

Ringworm may be spread in several ways, but most commonly is by direct contact with an infected animal or infection from contamination in the environment. 

Ringworm is a major environmental concern, as the fungus can remain viable on fomites (inanimate objects that carry an organism) such as kennels, blankets, toys, etc. for several months. 

Ringworm is more common in young and immunocompromised animals, particularly those coming from high volume animal situations such as shelters, rescues, etc. These areas are more high risk because animals are housed close together and in confined spaces. This is why ringworm is particularly common in kittens, as young litters are often kept together in the same confined space.

What does ringworm look like in pets? In people?

Typically pets will experience areas of hair loss with scaling/crusting. It may or may not also be red at the site. Sometimes lesions are so mild hardly any changes are noticeable.

Pets with ringworm may or may not be pruritic (itchy). 

While ringworm can be seen anywhere, the most common locations where lesions are seen include the head/face and limbs/feet.

People often get the more classic “ring like” lesion on their skin, but it may be as simple as a red circular areas. The lesions are also typically itchy, but do not have to be.

Can it be treated? 

Ringworm can absolutely be treated, though it takes diligence on everyone’s part. Lesions on animals may be treatable with topical therapy alone including antifungal ointments and/or medicated fungal bathes. These are safe and effective, but can be challenging to do for cats. Oral antifungals may also be used for more severe cases. 

Treatment often needs to be continued for several weeks.

• Treating the environment is just as important. 
  • • Ideally infected pets should be quarantined for the first few weeks of treatment to an easily cleanable area such as a bathroom/laundry room. This will localize any shedding of fungal spores. These rooms also have surfaces that are easily bleached. Ringworm in the environment is very susceptible to bleach based cleaners.
    • Clean any areas possible with an appropriately diluted bleach based cleaner.
    • Vacuum carpeted areas. 
    • Wash any common bedding/blankets that your pet has come in contact with in hot water.
    • Wearing long sleeves and gloves when handling your pet, as well as good hand hygiene are also essential to decreasing chances of becoming infected yourself. 

Can it be prevented?

Avoiding exposure all together is unlikely, so good hygiene and environmental management is key in these cases. While this also falls on breeders, rescues, etc., it is important for pet owners and new adopters to be on the lookout for signs of ringworm. 

Healthy adults are at low risk of infection, unless spores have access to an open scratch/wound. Those at higher risk include the elderly, children, and immunocompromised individuals.

What should I do if I think I have it?

If you believe you have ringworm, please do not ask your vet for treatment. Contact your doctor at your local GP surgery to schedule a consultation or to get recommendations.